Showing posts with label push-in therapy. Show all posts
Showing posts with label push-in therapy. Show all posts


Do you use carrier phrase sentence starters in speech therapy? I do. ALL. THE. TIME.

Why should I use carrier phrases?
Sentence starters help to increase mean length of utterance. Students feel success knowing they can read many of the words in the phrases, even if they are non-readers, the repetition of the phrases quickly makes them readers! They often want to self select a carrier phrase strip to use yielding engagement in the activity.

How can I use carrier phrases?
I use my handy ring of carrier phrase sentence starters with almost any activity I’m using in therapy. Here are some easy ideas:
  • Pair with a story read aloud for targeting grammatical structures (He has... They are...), labeling (I see... I found...) and categorizing and describing (A...is (a type of)... A...is/has (attributes)... A...can (function)...).
  • Pair with articulation cards to move to the phrase and sentence level during therapy. I don’t often wait to use my carrier phrases. Once a target can be used correctly at the word level, we are quickly trying a carrier phrase!
  • Pair with vocabulary cards for labeling (I have... It is...) or describing (A...is/has (attributes)...).
  • Pair with mini objects for labeling (I found... I see...) or describing (using the interactive pieces).
  • Use during group conversations to aid communication attempts (I like... He is... I want... Can I...)

Where can I get a set of carrier phrases?
Getting your own set of carrier phrases to use in all your speech therapy sessions is free and easy. Don’t miss out on downloading this free resource to aid in expanding student utterances! Simply click here to sign up to download this must have resource.














Do you have students that are stimuable for all speech sounds, just require a model or cue? I’ve started using these bookmarks for quick drill classroom practice to aid automaticity and promote generalization. I’m in classrooms all day long and accustomed to the flow of most rooms. Taking 5 minutes to work with these students using Speech Sound Bookmarks is helping me fit this additional service delivery into my schedule. 

I print on card stock and cut multiple copies, then clip together individualized packs for these quick drill students. I throw them in my therapy bag so they are ready when I’m near that student. I pull out the bookmark or stack and drill with the student for 5 minutes and then leave the bookmark behind for their classroom book box or take home folder. The next week, I switch out the sound, if the student has more than one target, or keep practicing the same targets. A good tip is to make 2 copies of each in case the one you leave behind gets misplaced. In my experience though, the bookmarks have remained part of their classroom!

Will this work for you? Students can create their own speech sound bookmark with words from the curriculum or a favorite book. You can also download these FREE bookmarks for every sound.








If you have been in any preschool or kindergarten classroom you have likely seen magnetic/foam letters or letter tiles in abundance. Since I spend most of my time pushing speech services into classrooms, I’ve been able to witness ways in which these manipulatives are being used. Making therapy curriculum meaningful while keeping a therapeutic focus is of primary importance. Students in kindergarten classrooms are learning letters, letter-sound correspondence, segmenting and blending, and sight words. I incorporated these skills with speech sound practice in developing my
Letter Tile Speech Mats.
*This product line now includes early and late articulation sounds as well as blends. See links at the end of this post.


In my experience, since many students require verbal, visual and tactile cues and prompts to aid in production of /s/ blends, I decided to start with this speech sound pattern in creating my speech sound mats. My expert young product reviewers gave these mats two thumbs up, asking if I could make more! I love that students can experience hands-on learning by selecting their letter tiles, segmenting and blending their target speech word and then showing confidence in reading sight words to extend to the phrase and sentence level. They can also use the pacing dots to touch and tap for sounds or words or even mark practice trials.






I keep all my mats in sheet protectors in a binder. For student use, I like to add cookie sheets for a designated “work area” and for attaching the magnetic letters. Here are a couple links (no affiliation) for letters if you don’t have access to those in classrooms. Just make sure you have more than one alphabet set of letters in order to have enough duplicates for group sessions.

magnetic/foam letters (I personally bought these and took out the numbers.)
letter tiles



If you could use a new activity that may connect with your students working on speech sounds, check out these products.

Letter Tile Speech Mats Early Sounds
Letter Tile Speech Mats Later Sounds
Letter Tile Speech Mats S, L, R Blends

Have you tried using magnetic letters in speech therapy?
Embrace change, step outside of your comfort zone, push speech therapy services into classrooms.   It is possible.




I made a commitment to push into classrooms regularly this year.  One week per month, I drop the lesson plans and materials organization in exchange for providing services in classrooms.  The result. I love it! I carry a clipboard with data sheets, a pen, and some comfy clothes to jump right into the mix or onto the floor.  My goals are simple.

Observe
Support
Promote Carryover
Collect

Observing students in their general education classrooms offers much more than I could have expected. Seeing my students as either active or passive participants and gaining a baseline of typical student performance offers ongoing assessment of student growth and needs.

Supporting both students and teachers is another goal. Just last month I pushed into a 3rd grade classroom while the teacher was prepping for state tests. While I like to think I can keep up with all the curriculum happenings and state mandated assessments, it's just not possible. Joining this classroom, I was able to play an active role in the discussion during the practice assessment. Earlier this year, I sat on the carpet with a student vying for teacher attention. While I am able to give students attention within my small groups within the speech room, the classroom teacher is spread so thin.  That day, I listened to reading, while sneaking in some vocabulary practice along the way.

Linking skills and strategies taught within the speech room to classroom tasks promotes carryover.  I had the opportunity to join a 2nd grade classroom practicing word reading fluency drills using an interactive SmartBoard activity. The word list contained consonant clusters (skr, st, bl, gr).  Among several students within that classroom, one student was working on /s/ blends within speech sessions. While she read fluently, she didn't attend to any of the blends. Guess what I grabbed on my way out...a copy of that word reading fluency list! Don't you know we worked on producing those words during our next pull-out session.

Which brings me to collecting. I collected that fluency list.  I jotted down Tier 2 words from a vocabulary discussion.  I took notes about strategies and skills that were important to the teacher/curriculum.  Of course I gathered data for those student objectives targeted and observed during my time.

Does every opportunity hit the jackpot? No. Neither does every pull-out group session. Yes, I said it! So, embrace change, step outside of your comfort zone, push into classrooms.  It is possible. It is beneficial.

If you haven't yet grabbed this Push In To Classroom Data Collection FREE resource head on over to my store, make yourself a set and attach to your clipboard. Exchange pull-out therapy for push-in once a month and let me know your thoughts!


I've decided {as with most of my decisions} to jump in with both feet and not look back.  Check out my SLPs Pushing In Series here to find out where I started.  Today, I am sharing where I am today.



Yes, I did receive some weird looks as I moved myself into classrooms to observe, chat with a small group of students, offer a strategy, scaffold, or provide a visual cue/prompt.  I reassured the teachers I was NOT observing them, merely I was immersing myself into the curriculum with the hope of gaining new knowledge about my students and hopefully earning a welcome for future returns.  I may just shout from the rooftops, I loved every minute of pushing into classrooms!  In small, controlled doses.  I'm calling it periodic push-in.  I'm not giving up my day job of pull-out speech language therapy.  Therapy is a necessary component for students identified with speech-language impairments.  In my opinion, therapy cannot take place solely in a large classroom setting or even in a small group within a large classroom setting, as I refer to as pull-away services.  Inclusion or push-in services is part of a continuum of service delivery options from which to choose.  A continuum is NECESSARY and so is individual and/or small group speech therapy services in the speech room!

If you want to give periodic push-in a try, I created a freebie for data collection.  You can find it in this post.  So far, most of my push-in times have been unplanned.  Students forgot to come to my room, so I went to their room and found a great activity going on, so I stayed.  A meeting was scheduled during a regular group time, so I pushed into music during my lunch.  Schedule changes created a domino effect, so I went with it...into the classroom.  Testing was going on here, so I went there.  You get the idea!

To offer a little more persuasion in hopes that you might too try periodic push-in, I've decided to take this whole week before winter break to only push into classrooms.  I am completely optimistic that this will be a grand week!  I started by developing a plan to push into classrooms by following my regular pull-out schedule.  Instead of having my students come to me, I will go to them.  This would work even better if my groups of students were only developed with students from one classroom, but that isn't always the case.  I sent out a staff e-mail {scary} and informed them of my decision to push-in, asking each teacher not to change anything.  If an activity throughout the week offered communicative opportunities, then I would be happy to push-in at the time instead.  I promised to bring my flexible brain!

So, I took my regular schedule and shrunk all the names leaving room to write in any invites.  I'm happy to report I have three so far!  I'll be involved in a "buddy" activity in kindergarten, watching some of my students present in a play in 2nd grade, and offering some help with independent studies in 4th grade.  I'm definitely ending the week with productions by our drama club, in which I volunteer to assist weekly as an after school activity.  In between those invites, hearing screening follow-ups, and scattered meetings, I hope to see all 80 of my students this week.

I promise to report successes and failures!  Happy last week before break speechies!



I'm also linking up {late} with Old School Speech's Week in Review since this is what I have planned for my week.  Despite taking tons of pictures last week of all my craftivities in speech, I neglected to include any in a post.  Best laid plans...



My Speech Therapy Push-in Series is rounding third and heading home hoping to bring in a win for the new school year.  You can start here and move here, here, and don't forget here!  Now it's time for a LINK UP.  How do you push-in to classrooms?  I'll start with my goals for the new school year!



Here's what I have planned {baby steps as I am taking on a new elementary school after leaving one that had me at hello 14 years ago}.

In looking at my caseload list, all of my students are in general education classrooms for this coming year. About half of my students are speech only, where I am their primary service provider.  Some of my related service students are in full co-teach classrooms where the regular education teacher and intervention specialist team it up all day, while others are in partial co-teach classrooms, as the "push" is for push-in, with some academic instruction provided outside of the general education classroom.

I just might make friends with the intervention specialists ASAP and ask them where they view speech and language therapy pushing into the classrooms they service.  Then, I can branch out to the regular education teachers in those classrooms.  Just maybe I can get my foot in the door, literally!

I will definitely reach out to kindergarten and 1st grade teachers to inquire about small group instruction {Daily 5 or center-based instruction} and offer to be included with caseload students and at-risk students should our schedules coincide.

And most definitely, I'll be realistic.  I am a new team member in this building.  I have to balance my clinical confidence {that may not come along for the ride} and ability to lay just slightly under the radar as the New Kid on the Block in order to establish rapport with a LARGE, NEW staff.

I think I am going to read this article on classroom-based narrative and vocabulary instruction.
Not to mention attempt to gain this working as a team perspective through professional learning communities.

Here's your chance {and please link up, I may even bust out a herke and cartwheel if you do}!  Just add the SLPs Pushing In graphic to a new post and add your link below {sorry no pictures, I am new at this}.  Please, whether you have some ideas on how you might start pushing in, do a little dabbling here and there, or are a veteran like Mia, I'd love to hear from you!




When the challenge of push-in speech therapy knocked me in the face again {there's that pendulum} after I pushed it mostly back out, I did what most SLPs do.  I consulted the experts.  It's called social networking these days. I sent out some e-mails and did a direct post on Instagram.  Grateful me and lucky for anyone reading, I received some positive responses!  For starters, Mia's guest post, from Putting Words in your Mouth, reminded us not to resist change, as the results can be wonderful!


Another positive face in the push-in arena is Nicole Allison from Allison's Speech Peeps.  I wanted to make sure you had a chance to check out her article, Three Easy Ways to Collaborate with Teachers.  Her post was featured here on ASHAsphere.  Thanks for sharing Nicole.  My glass is filling up!  Why?  Nicole reminds us to keep everything in perspective.  Don't let the plate overflow.  She says to make a goal for ONE idea each year moving toward collaboration.  Go ahead, read it!  I'll wait!

Check back tomorrow to see how I'm planning to move forward and see if any other bloggers will add even more practical encouragement!




I'm back with another post in my Speech Therapy Push-in Series, which started here and continued here.



If you have stopped by today, you are in for a real treat!  Mia, from Putting Words in Your Mouth, is here with a guest post.  Don't mind me for a moment as I replace my jaw drop of amazement after reading her post.  It's not only packed with why, how, and suggestions for making push-in work, it is truly a real honest perspective, full of inspiration.  So, enough of my babbling, on with the post!

I'm so thrilled to be a guest here SparklleSLP's lovely blog to put in my cents about a topic some of you may have mixed feelings about.  

If you're "pushing in" or doing inclusion (as we call it) to service your language disabled students, it's just plain weird at first! It starts off feeling awkward, uncomfortable, and a bit scary.  We've been PUSHED out of our boxes. It can leave you feeling useless and unproductive... OR it can be wonderful! 

I've been a school based SLP for almost 19 years in south Louisiana, and I've been "pushing in" for about 9 years.  Please allow me dish out the 411 on why to do it,  how to do it,  and lots of ways to make it work! 

It wasn't easy to change our mindset from "pulling out" to "pushing in."  
We resisted change.  We felt safe and in control and oh so happy in our little speech rooms, and our kids loved to "come to speech." 

Still, those of us practicing speech-language pathology in schools had to face facts, our role in the schools is to impact student progress in the curriculum by addressing the deficits preventing progress. 
Stuff like that happens in the classroom.  That's where the action is. 

Hey, we can do that! We are the language specialists on our campuses, and it's up to us to use our expertise to help our students be as successful as they can be.  As much as it is out of our comfort zone, there are advantages to us providing services in the classroom. 

Don't get me wrong, there are as many great reasons to "pull out" as there are to "push in," and we all know what those are.  Personally, I am currently using a combo approach to therapy- which is proving be the most effective approach for most of my students.  However, with the push to push in, I'm here to tell you, it's gonna be okay.  You might even like it! 
Here's why it can be a good thing and how to do it make it happen:

Why is this good for our kids? 
1) Addressing skills in the classroom- where the action is- where the kids live 7 hours a day- makes for better generalization of skills
2) We can see firsthand the child's immediate needs in the classroom and address it - BAM! 
3) We see our students amongst typical children in their element.  (Sometimes I forget what typical children are like!) 
4) Other professionals can learn from us, and other children reap the rewards of our genius ;)

Yep, there will be glitches....
1) We don't always get to address the skills that we know to be deficit (because the CELF told us so)
2) We don't get as much one-on-one "face time" with our students.
3) We lose control of our agenda. 
4) Let's face it, it's hard to collect data (a.k.a tally) in the classroom. We are tallying machines. We don't like things coming in between us and our tallies!  
5) We may encounter uncooperative parties. As fabulous as we are, not everyone will want us in their territory. 

What should you do?  
If at all possible, work with administration to pick the right teachers for your students and group them together as much as possible.  Clustering students and effective scheduling is a must for this to be successful! If you've "sold" yourself and what you can do for students to your principal in the past, this is where you will reap the benefits.  If you haven't made a case to your administrators about the good you can do on campus, this is the time to do it.  

If you can't pick your teachers. that's okay. You are the language master. Use your verbal and nonverbal language to become a fixture in whatever classrooms your students land in.  Read your teacher and adapt to her style, all the while showing what an asset you can be.  Obviously, don't charge in and lay down the law.  Have sincere talks about how you can impact student learning.  Sell her on the power of two in a classroom.  Then do your thing.  If you're reliable, punctual, helpful and productive,  soon she will wonder how she ever lived without you.    

I've done "inclusion" with all kinds of teachers.  The kind that forget why you're there.  The kind that SHUSH you.  The kind that think my kids are my kids and not her kids.  The kind that think I can only do creative activities because I have so much more time than her.  The kind that leave the room when I walk in, as if we were tag team wrestlers. The kind that give me carte blanche to do anything I want.  The kind that beg me to come more.  The kind that beg me to show them how to do that and ask to borrow my lessons.  The kind that put my name on their door.  

My co worker of 18 years, Mrs. Schexnaydre,  is the dream inclusion teacher.  I hope you all get to work with a teacher like her in your career.  She lights up when I walk in and wants to hear my ideas.  She says her class is as much mine as it is hers.  She puts my name on the door under her name- and the name of everyone who works in her room. She's even put my family photo on her class bookshelf.  Wow.


Want some advice from Mrs. Schexnaydre?  
When I asked what her advice would be for SLPs coming into a general ed. class, she said...

1) Have a positive attitude.  No one wants a "Negative Nelly" in their space. 
2) Don't be overly loud or fussy with the children. Keep it positive. 
3) Come in with ideas and don't be afraid to share your ways of doing things- in a positive way. 
A good teacher will want to learn.
4) If you do something with my inclusion section class, please let me use it with my other sections, too. 
5)  Command the classroom. Wimps in a classroom are of no use.   
6) Don't act like a visitor.  Come in and teach and be helpful.  Don't just observe or act like an assistant. 
Be my co-teacher!  

So how do you co-teach? 

That is the big challenge! 
There are several ways to get the job done but with all of them, keep these ideas in mind: 

Be open to working with your individual students, small groups, or the whole class!
Co-teaching can be done anywhere- not just ELA class (although that's my fave). 
Think about what you could do at PE! In the cafeteria! On the playground!  On field trips! 

Here are the co-teaching models that I have used; some are better than others, but they all work with pushing in

1) Speak and Add Model
One professional delivers the lesson and the other adds, expands, questions, rephrases, gives examples, etc. Typically the teacher does the teaching and we do the "speak and add," BUT don't forget that we can flip that script where WE are delivering the lesson and the teacher "speaks and adds." 
This isn't rocket science, but it does help students to hear information in another way.  If we are the one speaking and adding, we can scaffold skills down and reword things so that our students can understand. 

2) Skills Groups Model
You and the teacher or other professionals divide students into 2-4 groups based on needs and each takes responsibility for their group.  Don't forget to add non-disabled students into your group or to switch groups occasionally.  This is a good way to teach specific skills or prerequisite skills our students lack.  We can even sneak our tally sheets into this model! 

3) Station Teaching Model
SLPs can be a station as part of a bigger class lesson! We prepare an activity with input from the teacher. We are responsible for our own planning and instruction. We teach a part of the lesson as a station that all students in the class rotate through. For instance, if the class is focusing on informational resources, your station could be about dictionaries. If the class skill is genre, your station could focus on one genre.  If the skill is figurative language, your station could address one type (similes, metaphors, hyperbole, idioms, etc).  You spend less time with each student but you reach more students this way,  and it creates a small student-therapist ratio. 

4) Parallel Instruction Model
You and teacher both develop a lesson on a topic/skill (either jointly or separately).  You can each put your own twist on it or cater to a specific learning style.  You deliver it to half of the class (yes, this usually requires you rearranging students and making some noise).  You may or may not switch so that all students get both lessons. This lowers the student/teacher ratio and gives you the face time you crave; albeit, the noise and commotion does take some getting used to. 

5) Adapting Model 
One teacher plans and delivers the lesson and the other provides adaptations for students who are struggling. Sometimes this is just necessary.  You have a student who needs your help now and you tend to that student.  You may feel like a para pro implementing this model... or worry that one student is getting much more of your attention than others, but it addresses a specific, immediate need. 

6) Teaming Model
You plan and implement the lesson together.  You use planned dialogue.  This requires prepping and staging which can be difficult with schedules and time constraints. If you have time to do this, it is the ultimate co-teaching.  In my inclusion classes, the teacher and I actually plan a skit of sorts.  We plan out how we will argue about how to write a topic sentence or how we will debate about main idea vs. supporting details.  On occasion I've busted into a class with a loud, fake story packed with interjections or figurative language to introduce our skill.  The drama makes a big impact on the students.  Each teacher has pre-planned parts or roles. You can even script conversations between you and the teacher for the students to "overhear" to teach skills like inferencing and drawing conclusions. 

Pushing in has helped me see my students in a new light.  It unveiled problems I hadn't fully realized the extent of (social problems, handwriting problems, anxiety over speaking in front of the whole class) and revealed strengths I would have never seen in my speech room.  Who knew that a couple of my students were little Picassos!  There were also a few teachers' pets that I had no idea about.  I learned which ones were extremely inattentive in the classroom even though they gave me their full attention in my small group.  I learned who looked truly sad in class and who spent time their time socializing and making everyone laugh. 

Moreover, I learned that I could make as much of a difference outside of my speech room as I could inside.  Don't be afraid to stretch out of your comfort zone and rock those classrooms with your talent! 

“Hide not your talents, they for use were made,
What's a sundial in the shade?” 

If you'd like to read more from me, please visit my blog at www.puttingwordsinyourmouthbymia.blogspot.com  
With the school year starting MONDAY (gasp!) for me, I plan on blogging a whole lot more about this topic! I'm excited about another year of co-teaching! 

and I'd love if you'd follow me in all of these other fun places...

www.pinterest.com/miamcd 

A huge thank 'ya to my friend, Sparklle SLP, for letting me ramble here on her blog! 

I'd love to hear YOUR tips for pushing in!  -Mia


Thank you Mia!  I love that you "pushed out" of your therapy room and have benefited in so many ways, my favorite being the ability to see your students in a new light!  The link up is approaching quickly.  I hope you will join in!


You can check out previous post on Push-in Speech Therapy here.

IMO...When the education pendulum throws you lemons, make lemonade!  

Change is inevitable!  

Blessed are those who are flexible for they shall not break!  

Be a mover and a shaker not a whiner and complainer!



Whatever you may be thinking, I'm sure we've all had similar thoughts about change in the field of education.  Pull-out, co-teach, inclusion, 3-1, collaboration, least restrictive environment, integrative treatment, consultative, self-contained...  And then there is push-in.  Is this a hot topic or old news?

Now I may or may not be known as the pushy SLP, so if the aforementioned is true, I may just be suited for pushing in...to classrooms.  And well I have and then I haven't.  Both for good reasons.

For starters, severity and nature of disability are major factors in my clinical decision making.  Is this a kindergartener with a severe phonological processing disorder, resulting in unintelligible speech, not recognizable by even caregivers on most occasions?  Is the kindergarten general education teacher and any other support staff (intervention specialists, reading specialists, tutors) engaging in classroom small group centers?  Should both answers be YES, then pull-out AND push-in is absolutely what I would and do provide for that child.  Intensive pull-out individualized instruction using evidenced-based practices to guide therapy for a phonological processing disorder AND classroom-based therapy in a small group push-in service targeting phonology and syntactical structures linked to the curriculum {enter my kindergarten centers binder}.


What about least restrictive environment {LRE}?  Is the student's LRE a self-contained classroom, with a smaller number of students, taught by an intervention specialist, and possibly supported by an educational assistant, with a curriculum that is modified to meet student needs?  I'll be there ALL day {and have been, even adapting an entire reading series to incorporate speech and language skills}.

Do I feel comfortable pushing into a general education classroom?  Tell me the grade and I'll give you the answer.  11th grade?  This fish is OUT OF WATER, flopping away quickly.  5th grade {and my room has literally sat sandwiched in between two classrooms for years}?  I'm standing in the back quietly {and did you forget I may be generally pushy}.  How about 1st grade?  Feeling pretty good.  Now give me a teacher in which I have a great rapport and has totally accommodated for my narrow scheduling window {not to mention is always on schedule when I arrive} and I'm feeling tulips and cupcakes!  

No, it is not all about ME, the SLP, but to be honest, confidence in your clinical expertise requires preparation for the demands of the general education curriculum and a level of comfort. 

So, why have I and then haven't I pushed into classrooms?  Because IMO sometimes it is best practice and sometimes it is just not what the SLP ordered.  I want to ask myself some questions.

What does the data say?  Is my presence more distracting rather than supportive?  Can I address the targets as identified on the child's educational plan?  Do I have staff willing to collaborate with me?  Am I comfortable collaborating with staff?  Does my schedule or the student's schedule allow it?  Am I prepared to handle the curriculum?  Am I confident in my clinical skills?  These questions and others are the reasons why I have and then haven't pushed into classrooms.

What is your opinion on push-in services?  I'd love to hear.



While this post could be extensive, opinionated, and tangential, the primary goal is to provide a definition of Push-in Speech Therapy along with some research links for inquiring minds.



ASHA provides this information on School-Based Service Delivery. The link indicates a process for moving toward change, with the goal of a more collaborative service delivery model, while also identifying an overview of the various service delivery models.

So, what is push-in therapy? Well, essentially, it is the opposite of pull-out therapy, traditionally what most think of when they view speech language therapy. One therapist within an individual or group setting in a separate room. The push-in model is providing therapy within the classroom. While push-in is not a new concept, this article from the ASHA Leader, identifies challenges and the slow progression of push-in as a service delivery option.

Other terms, although not completely synonymous, include co-teach, classroom-based, and inclusion. Regardless of the semantics involved, integrating speech language therapy services into the classroom is a topic of relevance for a school-based therapist.

Are you currently researching this service delivery option?  What evidence have you found?







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